Back to the frontline

Politicised by her years as an NHS nurse, the Tory shadow junior health minister says her passion for mental health is shared by her party. She tells Mary O'Hara 'there won't be any raids' on the service when money is tight

Politicians need to be more 'imaginative and creative' when helping people with mental health problems into work, says Anne Milton. Photograph: Martin Godwin

She is a former nurse who was based for most of her career in disadvantaged parts of the East End of London, spent time as a union shop steward, and she openly advocates a "better mix" of people in parliament. Anne Milton, it would be fair to say, is far from the traditional image of a Tory shadow minister.

As a relative newcomer to politics, the party's junior shadow health minister is most visibly at ease talking about her career within the NHS, and how it shaped her politics. A health service employee for a quarter of a century – she still refers to herself as a nurse, despite moving into the political arena more than a decade ago as a borough councillor – Milton regards her "frontline" health service experience as a rare asset in a political landscape that draws increasingly from a narrower group of professions, such as lawyers, on both sides of the House of Commons.

"The most important thing about parliament I feel is that there's a mix," she says. "The mix is what's so valuable, but I do feel frontline experience of delivery of the public services is very important, because that's where a lot of government money is spent and what a lot of public attention is on." Being a former nurse in parliament brings "a different dimension" to how she approaches the jobs of MP and shadow cabinet member, she says.

Her tone turns conversational when speaking of her time in the health service and of nursing in general, but it doesn't get in the way of railing against what she sees as government meddling in the "autonomy" of nursing care. "As a nurse, all you want to do is to get on and care for the people you look after," she insists.

Milton's time within the NHS politicised her early on. "I lived through the politics of the 80s, which was very tricky," she explains. "I was a [shop] steward for the RCN [Royal College of Nursing], which was really interesting actually. It was a fabulous insight. I can remember a nursing officer bringing a patient up to the ward because there wasn't a porter around. The porters went on strike for 24 hours. I suppose I was politicised because the unions were really [too] strong."

Whatever topic Milton is on, however, the discussion veers time and again toward mental health. She wants to talk, she says, about reducing stigma and the problems associated with it, and she sounds genuinely passionate when she does. "There have in the past been negative stories in the media. It's about a schizophrenic who kills somebody." Ever the politician though, she adds: "Finally we have an opportunity to move on from that."

Priorities changed

Historically, mental health is an area languishing at the bottom of the Tory policy food chain, and was relegated under the last Conservative government to the status of Cinderella service. But Milton insists that that has changed for good. The reason she wants to influence mental health policy is because "it has been the issue that nobody else will champion".

Over the last couple of years, the Conservatives have adopted a number of mental health issues as their own – notably, mixed sex wards, and violence in psychiatric inpatient facilities – and it has discovered a new-found commitment to mental health and wellbeing. Milton puts this burst of enthusiasm directly down to David Cameron. "I think some of it has arisen from an understanding by David Cameron that, actually, the wellbeing of us as individuals, us as communities, us as families, is fundamental to the success of us as a society."

She dismisses any suggestion that this is mere rhetoric and insists that mental health services would not suffer under the Tories. "We have no plans to cut mental health services," she says. "There won't be any raids on mental health services, which are often seen as a soft target when money is tight. What is clear is that, for too long, mental health has not been given the priority it deserves, and therefore has often been vulnerable to funding cuts.

"We know that the level of resources going to mental health services has not kept pace with the increases provided to the rest of the NHS. I want to see a funding system that appreciates the importance of quality mental health care for everyone, and acknowledges the stark economic consequences of not delivering it."

Yet she is aware that, in the runup to the general election, Labour could exploit the fact that funding for mental health provision has increased markedly in the last decade.

However, when it comes to pinning her down on how the Conservatives would change mental health provision in government, she offers little in the way of specific alternative policies. She says a "huge amount needs to be done" to improve mental health care generally, and singles out prisons as an example of an area worthy of attention. Echoing the sentiments of prison reform groups, she argues that prisons have evolved into institutions where large numbers of people with mental health problems end up being corralled, rather than adequately treated. The situation has created, she suggests, "a new breed of psychiatric nurses who are prison wardens". Politicians need to be more "imaginative and creative", she argues, when it comes to helping people with long-term mental health problems in to work.

Yet when the Conservative party published its first substantive insight under Cameron on the future of the NHS last year – Renewal: Plan for a Better NHS – the document barely touched on mental health, apart from the issue of violence on wards. It is unlikely that anything resembling real flesh will be put on the bones of Conservative mental health policy before the end of this year – a formal announcement of a strategy is not expected until December.

Slow progress

Milton's shadow portfolio also incorporates hospital-acquired infections such as MRSA, something she accuses the government of being "very slow" to address. Predictably perhaps, she takes a swipe at ministers for a preoccupation with targets across the NHS. "If you have targets for the number of operations you do and you get waiting lists down, perfect," she says. "We want waiting lists down. We want operations done. But if you have an outbreak of an infection, you probably need to cancel the operations in order to isolate patients to ensure that you get the infection under control. Your waiting list is going to go up. That's the trouble. That's where targets distort the clinical imperatives and providing the best care possible."

If Milton gets the opportunity to champion mental health issues as part of a Conservative government, she may have an uphill battle on her hands, especially if the public finances are squeezed even further. But if she is fazed about the prospect it doesn't show. What really matters as far as the Tories are concerned, Milton claims, is that mental health is for the first time being highlighted as a priority right at the top of the party. As she says: "It's very easy to come up with a lot of fine words. You actually have to put in place the mechanisms to deliver the change you want. But it first does have to be a priority."

Curriculum Vitae

Age 53.

Status Married; four children.

Home Guildford, Surrey.

Education Haywards Heath Grammar School, West Sussex; St Bartholomew's hospital school of nursing, London; South Bank Polytechnic, London (diploma in district nursing).